Relationship between thyroid function and ICU mortality (sick euthyroid syndrome)
Keywords:APACHE II, ICU patients, Sick euthyroid syndrome, TFT
Background: Sick euthyroid syndrome refers to alterations that occur in thyroid hormone levels in response to any critical illness like sepsis, ARDS, patients on mechanical ventilation and also any ICU patients. This study aimed at the relationship between thyroid hormone level changes and critical illness in ICU patients and predict the mortality based on thyroid hormone levels.
Methods: A prospective study was designed to carry out in intensive care unit (ICU), Institute of internal medicine, Rajiv Gandhi government general hospital, Chennai for six months from May to August 2015. A total of 40 patients were selected who fulfilled the selection criteria.
Results: APACHE II scores were calculated for all the 40 patients to assess whether thyroid function tests could independently predict the outcome of the patients. Again, the thyroid profile was compared with APACHE II scores in predicting the outcome. Values showed statistically significance.
Conclusions: Thyroid profile can be used as an independent factor in predicting the outcome of the patients. Thyroid profile can also increase the sensitivity of APACHE II score in predicting the outcome.
Qari FA. Thyroid function status and its impact on clinical outcome in patients admitted to critical care. Pak J Med Sci. 2015;31(4):915-9.
Neto AM, Zantut-Wittmann DE. Abnormalities of Thyroid Hormone Metabolism during Systemic Illness: The Low T3 Syndrome in Different Clinical Settings. Int J Endocrinol. 2016;2016:2157583.
Euthyroid Sick Syndrome. Available at http://emedicine.medscape.com/article/118651-overview. Accessed 10 March 2017.
Nafae RM, Mohammed MA, Morsi AF, Ibrahim DA. Thyroid function in respiratory failure patients. Egypt J Chest Dis Tuberc. 2014;63(2):513-21.
Topal Y, Sebe A, Ay MO, Açıkalın A, Karanlık M, Topal M, et al. Investigation of the relationship between thyroid hormone levels and mortality in old patients hospitalized in an internal medicine intensive care unit from the emergency service. JAEM. 2014;13:71-4.
Wang F, Pan W, Wang H, Wang S, Pan S, Ge J. Relationship between thyroid function and ICU mortality: a prospective observation study. Crit Care. 2012;16(1):R11.
Chinga-Alayo E, Villena J, Evans AT, Zimic M. Thyroid hormone levels improve the prediction of mortality among patients admitted to the intensive care unit. Intensive Care Med. 2005;31(10):1356-61.
Suresh M, Srivastava NK, Jain AK, Nandy P. Thyroid dysfunction in critically ill patients in a tertiary care hospital in Sikkim, India. Thyroid Res Pract. 2017;14:58-62.